Dithranol's Danger: A Cautionary Tale of Accidental Exposure in Children
"Learn how a common psoriasis treatment can cause severe skin reactions in children and how to prevent accidental exposure."
Atopic dermatitis (AD), a recurrent inflammatory skin disorder, affects many children. Characterized by erythematous and exudative lesions in its acute phase and lichenification and crusting in its chronic form, AD can significantly impact a child's quality of life. While often idiopathic, a substantial number of cases are linked to allergen sensitization, making the skin's role in allergic reactions increasingly significant.
Adverse drug reactions, including those stemming from accidental exposure, pose a considerable public health challenge. These reactions are associated with high morbidity, significant socioeconomic costs, and potential fatalities. The increasing incidence of drug-induced toxicity, whether through ingestion or skin contact, underscores the importance of ongoing education and vigilance.
This article delves into a case involving a 2.5-year-old girl with atopic dermatitis who experienced intensified, atypical inflammatory skin lesions due to accidental exposure to dithranol, a medication used to treat psoriasis. This incident serves as a crucial reminder of the potential dangers and the need for heightened awareness in managing medications around children.
What Happened? A Case of Mistaken Medication
The young girl, already diagnosed with AD at two months old, had been following a dairy-free diet with standard AD treatments, leading to partial improvement. At 14 months, allergy testing revealed a milk sensitivity, prompting her return to the dairy-free diet. Her condition was relatively stable until she presented with a sudden flare-up of intense skin lesions and severe itching.
- Urticaria: Characterized by itchy wheals, which were absent in this case.
- Erysipelas: Ruled out due to the absence of general symptoms, inflammatory markers, and the extensive, multifocal nature of the skin changes.
- Contact Dermatitis: Initially considered less likely due to the lack of a clear history of exposure to cosmetics, chemicals, plants, or sunlight.
Preventing Accidental Exposure: A Call for Vigilance
This case underscores the critical need for caution when using medications like dithranol, especially in households with children. Proper storage, clear communication, and heightened awareness can prevent accidental exposures and protect vulnerable individuals from harm. Medical errors, including incorrectly administered drugs, are a leading cause of toxicity in children, highlighting the importance of diligence in medication management.